What's Causing Your Kidney Pain—and When Should You See a Doctor?

The kidneys are an important part of your urinary system and have several important functions. They work to remove waste products and excess liquids from the body, balance the charged particles (known as electrolytes) in your blood, and help regulate your blood pressure.

Your kidneys are located just below your ribcage on both sides of your spine. Because of their location and the type of nerves involved, kidney pain often feels like it is coming from the upper back or sides of your back. But sometimes it isn’t always obvious whether the pain you're experiencing is due to a kidney-related condition or another cause. During your diagnostic process, your healthcare provider can help you understand the underlying cause of your symptoms.

It's worth noting that some kinds of kidney problems are painless. However, some kidney conditions, like a kidney infection, do cause pain. If you're experiencing kidney pain, it's important to seek treatment right away to reduce your risk of developing long-lasting kidney damage.

Potential Causes of Kidney Pain

The two most common causes of kidney pain are kidney infections and kidney stones—both of which cause acute renal injury. An acute renal injury happens when your kidneys become injured suddenly. But, other underlying problems can also cause you to feel pain in and around your kidneys.

Kidney Infection

A bacterial kidney infection (medically known as pyelonephritis) is one of the most common reasons you'll develop pain in your kidneys. Back pain caused by a kidney infection tends to be dull and steady. The area may also hurt if you press on your back or abdomen. Kidney pain due to a kidney infection may occur on one or both sides of your back. It's also possible for the pain to radiate down into your abdomen and groin.

Kidney infections are an advanced type of urinary tract infection that develops when bacteria enter your urinary tract and travel up to your kidneys. With a kidney infection, you'll likely also experience other symptoms alongside pain. These symptoms include:

• Urinating frequently
• Burning or pain while peeing
• Fever
• Chills
• Nausea or vomiting
• Pus or blood in the urine

It's important to note that due to differences in anatomy, people assigned female at birth are more likely to develop kidney infections more often than their male counterparts.

Kidney Stones

Kidney stones can also cause pain in the upper back or on the sides of your back. It's also common for the pain to radiate from the upper back down to the abdomen and groin. While kidney infections are more common in assigned females, people assigned male at birth have a higher likelihood of developing kidney stones. 

In many cases, kidney stones don't cause any pain until they move through the ureters—the tubes that connect your kidneys to your bladder. When the stones get stuck or squeezed inside the ureters, you'll likely experience pain, nausea, and blood in the urine when you pee.

The pain from a kidney stone can be sharp and very severe—sometimes even enough to wake you from your sleep. The intense pain can come and go as the stone(s) moves along the urinary tract. This on-and-off pattern is medically called renal colic. While less common, a kidney stone can also lead to a kidney infection, causing more pain, fever, and chills.

Other Causes

While kidney stones and kidney infections are the most common causes of acute kidney injuries, pain can also occur due to the following:

• Trauma to the kidneys
• Severe dehydration
• Side effects of certain medications
• Very low blood pressure
• Autoimmune disorders
• Blockages in the flow of urine, such as cancer cells or a tumor

Regardless of the exact cause, an acute kidney injury can affect how well your kidneys function. In most cases, your kidney function will completely return to normal after the health condition that is causing your symptoms resolves. But in more severe cases, some degree of kidney damage may be permanent.

It's worth noting that certain factors can increase your risk of developing an acute kidney injury—and therefore, experiencing kidney pain. These risk factors include:

• Being of older age
• Living with diabetes, high blood pressure, liver disease, and heart failure
• Experiencing a high-risk or emergency surgery

When to Contact a Healthcare Provider

If you have any suspicion that you're experiencing kidney pain, it's important to seek medical care promptly. It's essential you contact your healthcare provider or visit an emergency room if your pain accompanies symptoms like persistent vomiting, fever, rash, dizziness, rapid heartbeat, or shortness of breath. Getting proper treatment in a timely manner is the best way to prevent long-term damage to your kidneys.

If you’ve had mild upper back or side pain for a while but without additional symptoms, it's still important to make an appointment with your healthcare provider. They can help evaluate what exactly is causing your pain and inform you about your treatment options.

Getting a Diagnosis

When you go in for your appointment, your healthcare provider will ask about your medical history, current symptoms, and any medication you're taking. They will also perform a physical exam which may involve them pressing on your back, abdomen, and above the groin to assess your pain. It's also standard practice for them to check your vital signs, such as your blood pressure, heart rate, and temperature.

In most cases, your medical history and physical exam are enough for your provider to tell whether a problem with your kidneys is causing your pain. For example, if you are an assigned female and have symptoms like frequent urinating, fever, and upper back pain, your provider will likely know that you are experiencing a kidney infection.

However, this doesn't mean that no additional testing is necessary. To confirm their hunch about your diagnosis or learn other important information, your healthcare provider may order a variety of tests, such as:

• Blood tests to check your kidney function, electrolyte levels, and complete blood count
• Urine tests to look for signs of a urinary tract infection or kidney infection
• Imaging tests (such as an ultrasound) to create detailed images of your kidneys to assess any signs of kidney injury or damage

Keep in mind: there may be additional causes of pain around your kidneys that aren't due to an underlying kidney infection, kidney stones, or other kidney injury. During the testing process, your provider will also try to rule out other conditions that may be causing your symptoms. These conditions include:

• Back pain due to a back strain or pulled muscle
• Inflammation in your appendix or gallbladder
• Costochondritis, or inflammation of the cartilage around your ribs
• Hernia
• Testicular torsion (twisted testicle) or testicular cancer
• Ovarian torsion (twisted ovary)
• Ectopic pregnancy

Treatments for Kidney Pain

Once you receive a proper diagnosis of the underlying cause of your symptoms, your healthcare provider will recommend certain treatments to help you reduce your pain and improve your quality of life. Treatments for kidney pain can vary a great deal, and will often depend on your exact symptoms and underlying cause.

If you have a kidney infection, antibiotics are the first line of treatment. There are a few options to help treat kidney stones though. For severe kidney stone pain, your provider may recommend pain relievers. Drinking plenty of water can also help you pass kidney stones quickly. In more severe cases, surgery may be necessary to remove or dissolve a large kidney stone safely.

You may also need other treatments if your test results show that your kidneys are functioning poorly. Some people may need to temporarily go on dialysis to help improve the function of their kidneys and replace the work their kidneys traditionally do, such as removing waste products and excess fluid.

How to Prevent Kidney Pain

In some cases, kidney pain can happen to due sudden trauma to your kidneys—so it's not always preventable. However, there are several strategies you can implement to lower your risk of developing kidney pain. These prevention methods include:

• Drinking plenty of water
• Regularly using the bathroom when you have to urinate and after having sex
• Wiping from front to back
• Managing underlying health conditions that can increase the risk of kidney problems, such as high blood pressure

Living With Kidney Pain

Chronic kidney pain is generally uncommon. In most cases, kidney pain is acute (or, short-term) and usually resolves with proper treatment. However, some conditions can cause chronic kidney pain, such as fluid-filled cysts in your kidneys caused by genetic diseases. Rare disorders like loin pain hematuria syndrome (LPHS) can also cause long-term kidney pain. If you're experiencing chronic kidney pain, your healthcare provider may recommend medication or surgery to treat symptoms.

It's worth noting that chronic kidney disease is a long-term condition, but doesn't always cause pain. Unlike acute kidney injuries, many kidney diseases cause graduate kidney damage, which comes with its own subset of symptoms. It's possible to have advanced kidney disease without having any pain at all. That said, don't use a lack of back pain as a sign about your overall kidney health. If you have any health conditions that increase your risk of kidney disease, it's important to monitor your health with regular visits to your healthcare provider.

A Quick Review

When you experience an acute kidney injury, such as stones, infections, or dehydration, it's common to experience kidney pain that manifests in your upper back and side. If you have kidney pain, it's essential to see your healthcare provider to get the treatment you need to reduce symptoms and improve your quality of life.